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HomeMy WebLinkAbout030-2124-30-000 tr p v1 � I h m o 0 N E °? 03 w ell >, o d � r � o 0 C tl o � (n m a� 0 c � o W � 0 0 m c m c 0 2 3 LL c @ O p � .O N � c co 7 Z fl! C N U) = O N Z ° w a m N z m c c O I 0 o Z d c o 3_ 0 1 ` LL (n c O O N h O N cu c y Z c w E iR . - o O Q O pj N c O d �7 O � N CY a� cm: N 'n a) 0. N N L c j _ O O Z (D Z N z N N i O a o o a 'M .�'. ~ c � 2 °' °.' E O- L o o a - m M 3 3 3 3 (D d o z • r�i ;� o a a a :3 a� U) Lo 0 CD ( J U o C) C (n N N N N N O CO 0 O nA iL co co m ) N -o d nrC) m c �i 0 O w C o c �►1 ° 3 H c O � o M L ' C N E C 'O N co c O N_ 'ma N 0 �p (O 0) d '% 'O C N O O o M N .c... O O Om U-) 00 -'"` O N `� U • O y O N U) O z Ln Z LL "' U) (C 3 # Q L d Q ~ 1 A 0 a 'i' 8 N 0 0 ■M0 c � @ ' ' 0 � CD rr . / ƒ w / 0 § 9 \ % § $ E I m m m£ o§ K ■ 4 ` m k\ ° G§ 2 . CD - m B & ` ) SOD Q 0 \ / ■ ` E E E § 8 t @ 2 o v> E% L ° © \ t \ \ . k o E § CD ® 3 k \ / . . / k \\ E. 2 E c CL a « } . » CL z 0 0 0 C, - ` ( { ■ ■ ■ k 7 QF q \ 3 / 7 7 { Q . \ z ƒ § ƒ 0 \ t{/ £� "ad- . a � a 7 § \ ƒ� %/ � k� / T E B = _ CD § 8 k / \ Z o § ■ a z o { 0 ` P R M. ■ A § U E £ § 2 z 2 \ z )\\ ; ® ƒ± X CD § � eeoo KEG: bq�0 k 5R ko � % j / 8■ 3 /k 2 E% t /§ . 0 Q � k \ 0 . 0 5 � < § \ _o §� �7 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479366 0 GENERP.L INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City village X Township Parcel Tax No: Moosia, Anil & Sunny St. Joseph, Town of 030 - 2124 -30 -000 CST BM Elev: Insp. BM lev: BM Description Section/Town /Range /Map No: G 25.30.20.1007 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 1 Dosing a / J Alt. BM ST• ��- Z' �(� _ C7 Aeration Bldg. Sewer Holding S t I nlet !T Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �/ 1� yl Dt Bottom �- Dosing Header /Man. q' _ Aeration Dist. Pipe a. Holding Bot. System 3 d Z� 90J�5 � Final Grade �� 0 . O PUMP /SIPHON INFORMATION C P 40 Manufacturer 0 Demand Stever 2 6` U Model Number Z 3 ! TDH Lift Frictio oss System Head 7 DH Ft Forcemain Le Dia. Dist. to well !-- SOIL ABSORPTION SYSTEM Q S BEDITRENCH Width / Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Man uier INFORMATION CHAMBER OR Typp Of System: � UNIT Model Number. 6 » K'_P �-U D IBUTION SYSTEM 4K Header/ nifold Distribution r x Hole Size x Hale Spacing ent t Air Intake f 4 t Pipes) /- 1 • r ength Dia Length (1 Dia 4 Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over 4 ,41— Depth Over xx Depth of 1 7��dd _ lSodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes L] No [.] Yes [J No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / /j �llnspection #2: / / Location: 1334 27th Street Hudson, WI 54016 (NE 1/4 SW 1/4 25 T30N R20W) Birch Park Lot 3 Parcel aN_o: 25.30.20,1007 1.) Alt BM Description = - 4 Z .ff �� emu" `��'�'"+� ?t 6_ (2 - 2.) Bldg sewer length = 3 S� i 5 4 - amount of cover \ f r Plan revision Required? j Yes o Use other side for additional information. Date Insepctor's Signature Cart. No. SBD -6710 (R.3197) Safety and Building ion County 201 W. Washington Ave. 7162 St. Croix Madison, WI 5370 - Site Address I►sconsin 27th Street 3 3 Department of Commerce p Permit Numb ' Sanitary Permit Application O anitary r 4171 �� 3m Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for seconda purposes Privacy Law, i I. Application Information - Please Print All Information TV -, (AIVED State Plan I.D. Number q {I Property Owner's Name A U G Parcel Number Moosia C� AAH L c '5 ul'" y O() 03 — '2! 12q- 30- OM(. )00 Property Owner's Mailing Address ROIX COUNTY Property Location 11 811 165 Ave. ZONING OFFICE a NE' / <; SW % <; S25; T30N, R20W City, State Zip Code Phone Number Lot Number Block Number New Richmond, WI 54017 (612)719 -6705 3 Subdivision Name CSM Number Birch Park 11. Type of Building (check all that apply) ✓ !) to S M ; "ak_ ❑ City_ X 1 or 2 Family Dwelling - Number of Bedrooms 4 Sew_ C®rt ❑Village t ❑Public /Commercial - Describe Use ��'`-""�v L ,, Q. - � y=--�� 'S X Town St. Joseph ❑ State Owned If 3 '�' " Nearest Road 27 Street III. Type of Permit: (Check only one box online A (numbering scheme for internal use). Complete line B if applicable) A. 1 New 2 Replacement System For County use System X 3 11 Replacement of 6 ❑ Addition to Tank Only Existin S stem i; B Check if Sanitary Permit Previously Issued Permit Number Date Issued k IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) y �I 44 X Non - Pressurized In- Ground 21 ❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑Holding Tank 48 ❑ Single Pass 51 ❑ Drip 45 El At-Grade 46 El Aerobic Treatment Unit 49 El Recirculating 0 k Other — n- f C ' V. Dispersal/Treat _ ent Area Information: 1 6 P4ew U-1 Z� Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation System Elevation Final Grade Required Proposed Rate(Gals. /Days /Sq.Ft.) Rate Elevation �A (Min. /Inch) 91.3' 94.3' 600 857.1 ft2 900ft2 .7 N/A VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic 1250 1250 1 Skaw Precast X Pump VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu ture MP /MPRS Number Business Phone Number Thomas D. Gustum 227618 715, 658 -1344 Plumber's Address (Street, City, State, Zip Code) N13450 937 St New Auburn, WI 54757 4- VIII. County /De artment Use Onl Approved ❑Disapproved Sanitary Permit Fee Includes Groundwater Date Issued Issuin Agent Signature (No Stamps) Surcharge Fee) C'D /�" Owner Adverse "► Determination IX. Conditions of Approval/Reasons for Disapproval 3 SYSTEM OWNER: �t`T� �20�^ Ply i� Cg,,,v �p 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained Gt. -�ae CW I�'h c�ea 2 � kbo_r 'e ess t✓i L�) as per management plan provided by plumber 2.` All setback requirements must be maintained I S t as per applicabl lekom @006(to the County only or the system on paper not less than 81/ x 11 inches in l 1 �O�m t, Q6L G 5E (� R�0�5 %O1) _I j' � � d A , 1 1 s SIM 1 I i I C � _N I \ \ 52z5 w°.a � N I t 1 I ,r I . I I 1 I I d t 11 ' ! t I N 1 � m 1 t I I I I I I I 1 v cc ' N 'CO 1 a I � L r ' I R I I r r I I � I • I L �• \f J3 2 ' cc 1 \ a E O d M n�v= `a 3 1 L 0 3 0 I o Z N S S 3 C2 w w Q V m m �I 6- ■ �� 0VI 1 I 1 I � rt " - _ �Id I I l4 N N I I e e c $ _— - o V ; N I I z � � 1 I 0 U) I I > I i I M 7 i i I r I N m m i I I 1 I I I i CL C14 to. I � I LO I a ct ca 0 I l� ' Y 1 3 7 y m 0) cr CU L O -0 ° B Y o U a. Ch av= a I O _ - c3 f2 6 W �> W w m w w Q Go 11 � U CO) co) 'n w 3 ° m m Vl - ■ G�Ga I z co I p C) m Q Chambers Page 1 of 4 Cover Page Project Name: Moosia 600 GPD Conventional Owner's Name Chris and Dale Moosia Owners Address 811 165th Ave. New Richmond, Wl. 54017 612- 719 -6705 Legal Description '/4, Sw Sec 25 ] T 30 N, R 20 Township St. Joseph County Saint Croix Subdivision Birch Park Lot# 3 Parcel ID# Table of Contents pg 1 Cover page 2 Calculations and Drawings 3 Management and Contingency Plan 4 Plot Map total # of pages: 4 Designer Name: Thomas Gustum License #: 227618 Date: 7/26/2005 Ph. #: 715 - 658=1344 Signature: Design Methods Used "IN- GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRIVATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD- 10705 -P (R.6/99) Chambers Page 2 of 4 Calculations and Drawings Site Condition Infiltration Elevations Site Type: Private - Cell #1 Cell #2 Cell #3 %Slope 6% Contour Elev: 94.30 0.001 0.00 Ft # of Bedrooms 4 Infiltration Elev: 91.30 0.00 0.00 Ft Depth to limiting factor 85 in Limiting Factor Elev: 87.22 N/A N/A Soil Application Rate: 0.7 gal /ft ^2 /day Treatment and Dispersal Zone: 4.08 N/A N/A Effluent Quality '[Etf #1 W Cover Material Required: 0 N/A N/A In Design Flow: 600 gal /day Finished Grade Over Cell: 94.30 N/A N/A Max BOD 220 mg /I Max TSS 150 mg /I Dis tribution Cell Septic Tank - -- - Choose chamber type: Ez Fl 3 x >- - Septic Tank Manufacturer: Skaw # of Cells�2 Septic Volume Chosen: 1250 Laying Length: 10.00 Ft Effluent Filter Selected: Biotube FTS0854 -36 EISA Determined Area: 50.0 Ft2 Note: Access opening of sufficient size to be provided to allow removal of filter. Opening Open Bottom Area: 35.30 Ft2 to terminate at or above grade. Chamber Height: 12 Inches Required Infiltrative Area: 857.1 Ft2 Actual Infiltration Area 900 Ft2 Total # of Chambers: 18 Total Cell Length: 180.0 Ft Cross Section of Septic Tank Cross Section of Cell vent in a ° Min. manhole cover \ 1T Min. Bamer Paper \ TT 1t3" Min / All joints to / be watertight D3034 or V i j �j' �A LEfflueht Sch40 Filter Pipe FI hnnl 3" Bedding Under Tank Plan View of Typical Cell v �> l V ��w> V A > < n - Z— �� Z- �� G Page 3 of 4 In- Ground System Management Plan pursuant to comm 83.54 W. A. C. Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical /biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems /failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and /or possibly cause it to freeze in winter conditions. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank or other components therein (including floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by removing the clogged bacterial mat, aggregate /leaching chamber cell, and distribution piping within the cell and replacing failing components in order to return system to proper working order as required. If repair is not feasible, a new system is to be constructed in a designated replacement area 2073 Wisconsin Department of Commerce SOIL EVALUATION REPORT page t of 3 Division of Safety and Buildings in ac wrdance with Comm 85, Wis. Adm. Code Gustum Septic Service Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference pant (BM), direction and parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Please print all information. iewed By Date Personal information you provide may be used for secondary purposes (Privacy Lew, s. 15.04 (1) (m)). I O Q Property Owner Property Location U Moosia, Chris And Dale Govt. Lot n/a NE 19 SW 1/4 S 25 T 30 NR 20 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 811 165th Ave. 3 n/a I Birch Park City State Zip Code Phone Number City Village W Town Nearest Road New Richmond WI 1 54017 1 612 - 719 - 6705 St.Joseph 27Th Street ✓: New Construction Use: ✓I Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material outwash plains Flood plain elevation, if applicable n/a General comments and recommendations: Recommend system elevation 3' below grade along contours. Boring # Boring ✓ Pit Ground Surface elev. 94.3 ft. Depth to limiting factor >85 in. Soil Application Rate Horizon Depth Dominant Color Redox Descrption Texture Structure Consistence Boundary Roots GPD/ft' 'Eff#1 'Eff#2 1 0 -7 10yr2/2 none sl 2mcr mvfr as 2f,lm 0.6 1.0 2 7 -18 10yr5/6 none gr. Is 1 msbk mvfr cw 2m 0.7 1.6 3 18 -54 10yr3/2 none Is 1 msbk mvfr cw - 0.6 1.6 4 54 -85 10yr4/4 none Is 1 msbk mvfr - - 0.7 1.6 ?I- 3�0 � ��d R3.1 , ! Z -� 2] Boring # Boring ✓' Pit Ground Surface elev. 93.8 ft. Depth to limiting factor >85 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fr `Eff#1 - Eff#2 1 0 -8 10yr3/2 none sl 2mcr mvfr as 2f,1m 0.6 1.0 2 8-18 10yr3/4 none sl 2msbk mvfr cw 1 m 0.6 1.0 3 18 -34 10yr4/6 none gr. Is 1 msbk mvfr cw - 0.7 1.6 4 34 -52 10yr5/6 none gr. s 0 sg ml cw - 0.7 1.6 5 52 -85 10yr6/4 none s 0 sg ml - - 0.7 1.6 i ' Effluent #1 = BOD ? 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD . 30 mg /L and TSS <30 mg /L CST Name (Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St., New Auburn, WI 54757 7120/2005 715 -658 -1344 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWN�ERSHIP CERTIFICATION FORM / Owner /Buyer �N� / / Mailing Address �7?A Property Address 33 (V ification required from Planning Department for new construction.) City /State Parcel Identification Number d3o - 01 2-4 - 36 - o - Jo �• °O� LEGAL DESCRIPTION Property Location N E 1 4 , 5M.) 'A Sec. �, T 36> R 20 W, Town of Subdivision _46'-0'4 ��'� , Lot # 3 . Certified Survey Map # Volume , Page # Warranty Deed # ��G /57� , Volume Page # Spec house i_, yes ❑ no Lot lines identifiable I l yes i no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix County Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating t t your se tic system has been maintained must be completed and returned to the St. Croix County Zoning Departme ithin des o three xpiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am /are the owner(s) of the property describ bove v' tue of w eed recorded in Register of Deeds Office. O S — SIGNAT RE OF APPLICANT DATE * * * * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. i 7761x7 �3 2 6 6 9 P 14 3 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIK CO., WI DOCUMENT TITLE RECEIVED FOR RECORD 10/05/2004 10:30AN WARRANTY DEED EXEMPT # WARRANTY DEED REC FEE: 13.00 BIRCH PARK, LLC, GRANTOR TTRRANS 434.70 COY CC FEE: PAGES: 2 Recording Area Name and Return Address Wilkerson & Hegna, P.L.L.P. 7300 Metro Boulevard, Suite. 300 Edina, Minnesota 55439 -2302 030- 2124 -30 -000 Parcel Identification Number (PIN) THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE This information must be completed by submitter. dammu wpe do return address. and Eff ((f required). Other Information such as the granting clauses, legal description, etc may be placed on dris first page of the document or may be placed on addlional pages of the document. Note. Use of this cover page adds one page to your document and $1 to the recordi r ke. Wisconsin SAaWA ti 59.43 04 WRDA 2/99 r - STATE BAR OF WISCONSIN FORM I - 1998 WARRANTY DEED U 2 6 6 9 P 1 4 `f b$cument Nurnber This Deed made between Birch Park, L.L. C. , a limited liability company under the la of the state of Minnesota Grantor, and Anil P. Moosai and Sunny Moosai, husband and wife as Joint Tenants Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate In St. Croix County, State of Wisconsin (the *Property'): Recording Area Name and Return Address Premier Title LLo arch Park 7300 Metro Blvd., #300 Edina, MN 55439 030- 2124 -30 -000 Parcel Identification Number (PIM This is not homestead property. (is) (is not) Together with all appurtenant rights, title and Interests. Grantor warrants that the title to the Property Is good. Indefeasible In fee simple and free and clear of encumbrances except all easements, reservations and restrictions of record, if any. Dated this 30th day of September 2004 (SEAL) BIRCH L C. (SEAL) * Bye am Waters, Its C of Manager (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of 9jdDCXdG,Minnesota ss. Hennepin County. authenticated this day of Personally came before me this day of September, 2004 the above named James M. Waters. the Chief Manager of Birch Park. L.L.C.. a Minnesota limited * liability company. on behalf of the LLC TITLE: MEMBER STATE BAR @#Z G "�°'• `— to AN N. yG,' iNG (If not, ` 1 t, ��` Notar ublic me known to be the person who executed the foregoing authorized by §706.06, nnesota ac 0 g the same. THIS INSTRUMENT WAS DRAFTED BY Wilkerson & Hegna, PLLP 7300 Metro Blvd., #300 Note ublic, State of Wisconsin Edina, MN 55439 My comm <.Inn is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary) Names of persons signing In any opacity must be typed or printed bola- their sigrnture. WARRANTY DEED STATE BAR OF WISCONSIN wlscororn Logo eler* Co., Inc. 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Rev b e Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ❑ )W Quest Development, Inc. Go Lot E 1/2 1/4 SW 1/4 S 25 T 30 N R 20 E(or)W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Suite 150 10700 Old County Road 15 3 Birch Park City State Zip Code Phone Number ity Fl Village ■ Town Nearest Road Plymouth MN 1 55441 1 ( 7�3 -595 -9512 County Road E a New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD Fl Replacement Public or commercial - Describe: _ ) I i Parent material 1.oess over out wash sands Flood Plain elevation if applicable XT A ft. General comments This site is suitable as a below ade conventio "s tem.D r and recommendations: ICI -C 1 �► 072 -: ,• ' C,�NT( Boring # Boring `s zIiNGOF a Pit Ground surface elev. 90.35 ft. Depth to limiting factor >96 , .S60 Al3pkation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boun Rbd GPD/fP in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10yr2 /2 is lfgr mvfr cs 2f .7 1.2 2 6 -32 10 r3/2 is lfgr mvfr cs 1f ,7 1.2 3 32 10yr3 /6 lvfs lfgr mvfr cs - .4 .6 4 48 -96 7.5yr4/6 s Osg ml - - .7 1.2 ❑ 2 ❑ Boring Boring # Q 99.60 >96 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 -6 10yr2/2 Is lfgr mvfr cs 2f .7 1.2 2 6 -32 10 r3/2 Is lfgr mvfr cs if .7 1.2 3 32 -96 7.5yr4/6 s Osg ml - - .7 1.2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = B < 30 mg /L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 12/08/01 715- 246 -2454 d r , . L f A L Property Owner Quest Development.Inc Parcel ID # Page 2 of 3 F 71 Boring Boring g 0 Pit Ground surface elev. 92.71 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3 /2 - is 1fgr mvfr cs 2f .7 1.2 2 10 -24 1 r3/3 - is lm r mvfr cs if .7 1.2 3 24 -48 7.5yr5/8 - lvfs lmgr mvfr cs - • .6 4 48 -96 7.5yr5/8 - s Osg ml - - .7 1.2 F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # ID Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. M- 8330Test (R.07 /00) l i r C o. r LA C�J Q0�a- , , 8 +� Q i %315 QII q 9.60 S1 r t33 go, � � b oa d wha4 o r 10 I� VVJ-4, 2. '39 4- Al 6ty i , vD i t1 /z2 0- L P/ , /v iSSv A-,I 45 OF j 69 30 • 2-0,3 • Z o • COD (:5B,v T` k11:5- v 30 • Z e)3 so • ouv G- �•GC�t/,SC� M�9 0 30 • 2- i 0 • &n7V 3� 0 d Z d A9 ' Om Ulbricht & Associates 7 Private Sewage Consultants D 3 055 855 O'Neil is. v " " Hudson, Wis. 54018 7f 5 - 77 3 y1{z-